Provider Demographics
NPI:1982429130
Name:DE GUZMAN, VERALYN JOYCE (FNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:VERALYN
Middle Name:JOYCE
Last Name:DE GUZMAN
Suffix:
Gender:F
Credentials:FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12995 NINEBARK ST
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-1211
Mailing Address - Country:US
Mailing Address - Phone:951-867-1542
Mailing Address - Fax:
Practice Address - Street 1:421 N BROOKHURST ST STE 228C
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5619
Practice Address - Country:US
Practice Address - Phone:714-442-3947
Practice Address - Fax:714-442-3921
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily